Bethsheba Johnson is a nurse practitioner at the Luck Care Center on the underserved South Side of Chicago, a pioneering private HIV/AIDS clinic owned and operated by African Americans, staffed by African Americans, and primarily serving African Americans. The clinic provides its patients with primary care, case management, counseling in treatment adherence, mental health, substance abuse, prevention and other support services. It also conducts clinical trials, studying how HIV and HIV treatment may differ in African Americans with HIV. Her husband, Dr. William Johnson, is the Luck Care Center's medical director and a leading specialist in HIV in African Americans.

What do you focus on in your own HIV/AIDS work?

Knowledge is power, so when we look at trying to empower a patient, we look at teaching them about their disease so that they understand it better. That understanding usually helps bring about a change in behavior.

So we do prevention with positives, we do the HIV life cycle, we do pathophysiology [changes in bodily functions caused by disease], and all these things at different intervals, depending on the patient. Either one-on-one, or in a treatment-adherence or PWA [People With AIDS] support group. We have a women's group that is basically just teaching empowerment, being able to say no, having safer sex.

Where is the most progress being made in combating the epidemic in the black community? Where is the least progress being made?

Unfortunately we have a lot of indigent people. If you don't have the basic necessities in life, you're not going to be worried about taking a pill. It really is important to have food to eat, a place to shelter. Those are the basic needs of a human being before we can even talk about HIV medication, adherence and other treatment issues.

What are the top myths about HIV that you encounter in the African-American community?

There are a lot of myths about where HIV comes from. Mosquitoes, polio vaccines, the government -- to kill all African Americans. I hear those things repeatedly. I also hear HIV medications just help you die quicker -- that they cause more harm than good.

Some patients actually do get sick from side effects of the medications, but that doesn't mean that the next patient will get those same symptoms. So I try to say, "These are the potential side effects, "potential" meaning that you may not get it, but it's possible."

How is the HIV epidemic different in the black community than other communities?

Now we're starting to look at that issue in depth. We've done most of our drug studies in the United States on white men. So now they're really trying to increase the number of races in clinical trials to look for pharmacogenomic [genetic-related responses to drug treatment] differences.

We're just starting to get a grip on that, knowing there are different drugs that are tolerated differently by different races. And that's true not just for HIV drugs but also, for example, blood-pressure medications.

I think there's a lot we still don't know. They're looking at differences between races, whether the HIV infection is more aggressive in African Americans than in others. Many African Americans who are infected are living in poverty -- the differences may appear to be caused by race or race-related genetic difference, but it could, in fact, be lifestyle conditions -- inequalities -- that make HIV appear to be more aggressive.

What are your hopes and fears for the next generation of African Americans as they face the risks of HIV?

I have hope that more people will start talking about this, since the numbers are so high in African Americans, especially women. That we'll be more open to talking about sexual risk factors, so that transmission is prevented. I have great fears for the children. I'm a mother of three, and it saddens me that things are in this state. I wonder what's going to happen to my youngest, who's just three. Will there be continuing generations?

In 2005, Bethsheba was one of 73 people in the United States who received an HIV Leadership Award from The Body. We interviewed each of the award recipients; click here to read the transcript.

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